[Histonet] ASCP Exam Long opinion

[Jasper, Thomas G.]

Hey Barry,

I appreciate your long opinion, at times life requires long opinions.  I agree with much of what you say and I will try to concisely explain how I see things.  I totally agree that elimination of the practical was a bad idea.  And I understand the arguments for getting rid of the practical.  Let's start with automated staining.  Unfortunately most labs in the clinical world of the US, Can., UK, Western Europe, S. Africa, Aus., NZ and Japan (sorry if I've omitted someone) have turned to this technology out of necessity.  This is due to staff shortages and for cost containment.  The consistency and reproducibility are greatly enhanced by reduction of variables (I know more science than art).  But there you are, so a lab's automated stainer produces a stain, candidates submit.  If this is the technology a candidate will likely use, that should be taken into consideration.                                                                                                               I expect a candidate to cut their own sections.  That would be subject to evaluation as it always was.  And I expect someone to know what an H and E or any other stain is supposed to look like, automated or not.  With so much emphasis on academics they should know what the stain looks like and why.  Heck, with all this automation you could even expect a basic level of understanding about the mechanics involved and make that part of the written exam.
Perhaps the elimination of the practical was not necessary, but a reassessment of the whole thing, or as you so cleverly stated "...what is needed for the entire system is a good enema!"  I agree with the statements from others that they want to know that folks who are certified can cut sections.  It is more balanced and despite all of our wonderful automation Histology is the one laboratory discipline that still requires a deft hand and an artistic eye.  I'm not aware of any automated substitute for manual dexterity.
I also agree with this whole ASCP/fox in the henhouse analogy of yours.  I understand we've got good intentions here, but there is a mindset, amongst certain pathologists, about cheap labor.  Despite pay increases in recent years (and I'm grateful) Histotechs overall, are the lowest paid laboratorians.  Increased educational requirements (which I believe in) still have not eradicated this mindset.  Please understand, I am not speaking about all pathologists, but there are enough to validate the analogy.
Now Barry, I think your educational background is great and I suspect you're a better man because of it.  It seems to me in this day and age that it would be near impossible to pull off.  We've taken incredible leaps in technology just for Histology alone.  I would be wary of an MLT or MT today that thought they could come into our Histology lab and perform at the level I expect (that whole dexterity thing again).  And frankly, I think it would be extremely difficult to go into the General Lab, Blood Bank, Chemistry, Special Hematology, Microbiology or any other sub-discipline and perform at an acceptable level.  Now do I think folks should have an understanding and appreciation for these other disciplines?  Absolutely.  And maybe that needs to be incorporated in Histology training at an academic level.  But doing the work is another thing entirely.
Anyway, I don't know if my opinion will count for much, but there you have it.  It would be nice to see some changes and I think reinstating the practical is worth considering.  I understand that logistical problems exist as well, along with some of the other subjective variables that Joe Nocito mentioned.  Maybe judges could be sent regional sites or something.  Anyway it's food for thought.
Thanks for letting me ramble.

Thomas Jasper HT (ASCP) BAS
AP Supervisor
SMDC - Duluth, MN

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Rittman,
Barry R
Sent: Thursday, February 01, 2007 10:17 AM
To: Histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] ASCP Exam Long opinion


Joe
You owe me big on this as I'm sure that it will take the flaming away
from you.

My personal opinion is that what is needed for the entire system is a
good enema!

First I have a lot of sympathy and admiration for people who prepare and
mark examinations, after all I do this a lot and it is a thankless task.
 
However, the concept of having an examination without a practical
component to certify individuals as competent is one of the most stupid
things I have ever heard (bearing in mind that I am in my late 60s and
have worked in labs since 1957 that should give you some idea of how
stupid I feel this is.)
I also felt that being able to send microscope slides in for evaluation
and being able use automatic slide stainers for preparation of such
slides comes a close second.
>From many comments I am assuming that what is behind this entire
movement to dumb down the process is financial.
This is the same mentality that is used in education nowadays. 
The question that is being asked seems to be what can we do with what we
have?  Put another way, how can we for example expand the work but use
the same number of people?
The question that should be asked is what resources do we need to get
the job done most efficiently? 
I feel that most jobs can be most efficiently carried out with highly
trained and happy individuals. The careers and well being of individuals
involved in the process appears in may labs to not be a high priority.

I was trained in England and so I feel that I perhaps have a broader
view of the training that is carried out in the States and I have seen
two retrograde steps.
The first was to remove histology from the med lab tech curriculum. The
second was to have evaluation of histotechs under the jurisdiction of
ASCP.
I think that ASCP does a great job in many ways, however this is akin to
having the fox in charge of the henhouse.
In many ways I feel that this has directly or indirectly contributed to
the low salaries for many histotechs.
I feel that what is required is a training and an examination system
that is on a national level and that will maintain standards of
excellence. 
I am not certain of the same system I trained under in England is still
in operation but I felt that it was a system that benefited both
employees and employers.
If you were employed in any medically associated  laboratory it was
mandatory for you to have one day and 1 evening of your own time for
training at a nationally recognized facility. 
The employer paid for your day off and the main requirement was that you
maintained good grades. This training covered several disciplines e.g.
histopathology, hematology and blood banking, histopathology,
bacteriology, clinical chemistry etc. Training took three years. At the
end of three years you took a written examination over all topics and if
you passed this a practical examination. The practical examinations were
at local centers. You were in a lab where you were presented with fresh
tissue, fluids, and supplies and a list of tasks to accomplish in a
morning. You multitasked - the order you carried out these tasks were
entirely up to you.
In the afternoon you had an oral examination from a panel of three
people.

If you passed all parts you were recognized as a qualified Med Lab Tech.
You could go into any lab in the country and would be guaranteed a
salary range and more importantly the laboratory you went to would know
that, regardless of the lab you had worked in,  that you had a set of
uniform  skills in the entire area. Everyone benefited from this.
If you wished you could carry out advanced training in areas such as
histopathology, bacteriology etc. this required a further two years.
The net result of all this was that many labs has people at all levels
of training who acted as mentors. There were clear cut career paths.
I hope that the employers who survived a hear attack at the prospect of
implementing such a system see the underlying message.
First you need to train people and not just in a limited area. 
Second that such training is often not available at the lab you are
working in and this requires a standardized training and evaluation
system.
Lastly that a specific career path is established for employees from day
one with obligations form both the employer and the employee.
While the federal government would totally screw up such a system we do
have an NSH that could set standards and allow each state to enforce
such standards.
Thank y'all who have read these ramblings.
I promise you that I am not smoking anything.
Barry





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